Cardiovascular Disease and Type 1 Diabetes

Event Details

Purpose of the Workshop

Cardiovascular disease remains the leading cause of death for people with type 1 diabetes, despite improvements in the control of glucose, blood pressure, and lipid levels. The pathophysiology, risk factors, and clinical course of cardiovascular disease in type 1 diabetes have features that are different from those for cardiovascular disease in people with type 2 diabetes or without diabetes, yet most of the clinical recommendations for people with type 1 diabetes are based on studies of these other populations. The goals of the workshop are the following:

Review the pathophysiology of atherosclerosis and myocardial infarction in people with type 1 diabetes.

Compare and contrast risk factors for cardiovascular disease that are general, diabetes-specific, and type 1 diabetes-specific.

Review the clinical presentation and course for acute coronary syndrome and stroke in type 1 diabetes.

Discuss and prioritize research questions for cardiovascular disease and type 1 diabetes.

Review and discuss the approaches and resources needed to address the high-priority research questions.

Discussion: What mechanisms are unique or prevalent in type 1 diabetes? How is the development of atherosclerotic plaques similar and different among type 1 and type 2 diabetes and non-diabetes? What are promising targets for biomarker and therapy development?

Discussion: Are we ready to build a risk calculator for type 1 diabetes? What would be the components? How might it differ from the clinical situation without diabetes or with type 2 diabetes? Are we missing important components? How good are the biomarkers to assess risk for individual patients and for stratification for clinical trials?

Discussion: What areas need more basic mechanistic studies in animal models or humans? What areas need better epidemiologic data? What research questions are ready for pilot clinical trials? What research questions are ready for phase II or III clinical trials? In which area(s) could we make the biggest impact on patient health? Consensus development on the top five research questions that will be the basis of discussion on Day 2.

5:30 p.m.

Adjournment Day 1

October 9, 2014

How do we proceed with the top five research questions?

8:00 a.m.

Introduction
Moderator: Dr. Nathan

For the research questions that depend on preclinical and translational work, what resources or tools are needed?
Panel: Dr. Karin Bornfeldt, Dr. Michael Brownlee, Dr. George King, and Dr. Ann Marie Schmidt (30 min)

For these research questions, are there alternative ways to conduct clinical trials than the traditional randomized trial? (60 min)

How could the Patient-Centered Outcomes Research Network (PCORnet) be applied to these research questions?
Dr. Robert Califf

What are the appropriate outcome measures for the clinical research questions? Do we have adequate surrogate end-points for pilot clinical trials?
Panel: Dr. Anne Sofie Astrup, Dr. Darren McGuire, Dr. Trevor Orchard, and Dr. John Spertus (30 min)

What recruitment strategies can be employed effectively for these research questions in type 1 diabetes adolescents and adults? How can we best involve the type 1 diabetes patient community?
Panel: Dr. George King, Dr. David Maahs, Dr. John Petrie and Dr. Rodica Pop-Busui (30 min)

How could registries, cohorts and biorepositories be used to answer these research questions? The program book will include summaries of cohorts and registries.
Panel: Dr. Helen Colhoun, Dr. Daniel Gordin, and Dr. Trevor Orchard